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Biomedical subjects

P Rantakallio

Publications and source records attributed to P Rantakallio.

At least 19 recordsLinked to original sources
PubMed1992

Maternal smoking during pregnancy and delinquency of the offspring: an association without causation?

The aim was to evaluate the association between maternal smoking in pregnancy and delinquency of the offspring in youth and early adulthood. The study population consisted of 5966 male members of the Northern Finland birth cohort of 1966, of whom 355 (6.0%) had committed a crime which led to a criminal record by early 1989, which was taken as an indicator of delinquency. Data collection was started during pregnancy and the development and health of the children was followed up continuously to the age of 14. The incidence of delinquency by the age of 22 was 4.6% among the sons of the mothers who did not smoke during pregnancy and 10.3% among those of the smokers. No clear dose-response gradient was observed, and those stopping smoking during the first trimester of the pregnancy had only a slightly smaller incidence of delinquency than those continuing smoking through pregnancy. The association of maternal smoking with delinquency was studied by controlling a number of social and demographic variables using an approach based on stratification by a confounder score. The adjusted incidence difference between smoking and non-smoking mothers was 4.1% (95% confidence interval [CI] : 2.5-5.8) and the ratio was 1.73 (95% CI : 1.41-2.12). A parallel analysis by logistic regression yielded an estimated odds ratio of 1.74 (95% CI : 1.37-2.11) for the same comparison. Even though the association between maternal smoking and delinquency of the offspring remained after adjustment for the available social and demographic factors, maternal smoking may be symptomatic of a certain lifestyle and norm-breaking behaviour which is likely to increase delinquency in the children rather than being an agent with a direct causal role. This is supported by the lack of any clear dose-response pattern and the minor importance of stopping smoking. Another possibility is that maternal smoking may cause some kind of brain damage which affects the behaviour of the child.

Adolescent↗
PubMed1992

Association of perinatal events, epilepsy, and central nervous system trauma with juvenile delinquency.

The association of perinatal events, childhood epilepsy, and central nervous system trauma with juvenile delinquency was studied prospectively in a geographically defined population of 5966 males in northern Finland. Those who had obtained a criminal record up to the age of 22 years, totalling 355, or 6.0%, were defined as delinquents. The incidence of delinquency was not increased in males with a birth weight less than 2500 g or greater than 4000 g, preterm births < 37 weeks' gestation, or those with perinatal brain damage or having epileptic seizures before 14 years of age. The incidence was increased by 6.8% in the group of males with birth weights less than 3500 g, but not significantly increased after standardisation for a number of social and demographic background variables. The incidence was increased by 10.3% among the males who had had a central nervous system trauma by the age of 14 years, however, and this factor remained significant when social and demographic factors were standardised by regression analysis, with an odds ratio of 1.9 for all males with a criminal record and an odds ratio of 3.15 for those who had committed a violent crime. Previous central nervous system trauma may be a cause of delinquency, or another possibility is that the type of behaviour pursued by males who are likely to commit a violent crime will expose them more often to accidents which can result in central nervous system trauma.

Adolescent↗
PubMed1991

The occurrence of acute otitis media in infants. A life-table analysis.

A random sample of 2512 children were monitored to an average age of two years to determine the occurrence of acute otitis media (AOM). A life-table methodology was employed in the analysis. The cumulative incidence of the first episode of AOM up to 12 months of age was 42.4% (95% confidence interval 40.4-44.4) and the corresponding figure up to 24 months of age was 71.0% (68.9-73.1). The incidence rate for all acute otitis media episodes was 0.93 episodes per child per year (0.90-0.96) during the first 24 months of life increasing in the spring and autumn. The risk of experiencing an episode of acute otitis media increased at the age of 6-12 months and decreased slowly during the second year of life. The results confirm the frequent nature of acute otitis media and stress the necessity for clear, consistent definition of the criteria for acute otitis media in epidemiological research.

Acute Disease↗
PubMed1991

Determinants of teenage smoking, with special reference to non-standard family background.

The prevalence of teenage smoking in a cohort of 12,058 subjects born in northern Finland in 1966 is discussed in terms of its social and family determinants, especially in "non-standard" families (with one or more of the parents absent for at least part of the child's upbringing). The prevalence of experimental or daily smoking was 67.4%, the rate being 65.5% in the standard, two-parent families and 75.5% in the non-standard families, the difference being statistically significant (p less than 0.001). The corresponding prevalence of daily smoking was 6.4%, but the rate was 5.1% in standard families and 12.1% in non-standard families (p less than 0.001). An elevated risk of smoking existed among adolescents who had experienced death of their father or divorce of their parents and among girls who had experienced death of their mother. Maternal smoking during pregnancy and maternal age under 20 years at the time of delivery increased the risk, while being the first-born child reduced it. Among family factors existing in 1980, paternal smoking increased the risk for both sexes, while more than three siblings, mother's unemployment or gainful employment (i.e. not a housewife) were associated with smoking by the boys as was urban living, and for the girls migration by the family to a town. The results suggest that juvenile smoking may be a kind of indicator of possible problems experienced by the parents and/or the adolescents themselves with respect to parenthood and family development.

Adolescent↗
PubMed1991

Fitting mixture models to birth weight data: a case study.

Birth weights by gestational age are compared in two birth cohorts from Northern Finland, the first from 1966 and the second from 1985-1986. A curious fact in the data is that mean birth weight before the 39th week was lower in the latter series although the mean birth weight for the total series was higher. Similar findings have been reported in other series. A mixture model with the nonparametric regression function is proposed for studying the hypothesis that the difference was caused by more frequent gross errors in gestational assessment in the earlier cohort. The probability of an error in gestational assessment then greatly depends on the observed gestational age, which makes the mixture model nonstandard. Maximum likelihood solutions to the parameters in the proposed model were computed employing the general expectation-maximization (EM) algorithm. A technique for studying the effect of errors on the intrauterine weight gain curve is proposed and applied to our two birth cohorts. The risk of underestimation of gestational age seems to be larger in the previous series and the differences between the growth curves almost totally vanish when "corrected" by means of the mixture model.

Algorithms↗
PubMed1990

Is a child's history of acute otitis media and respiratory infection already determined in the antenatal and perinatal period?

A random sample of 2512 children were followed up from fetal period to the age of two years and the relation of various antenatal and perinatal factors to acute respiratory infection, wheezy bronchitis and otitis media was studied. A model containing the relationships between the variables was used as a basis for the analysis and the powerful confounding effects of postnatal factors were standardized. Acute otitis media with effusion (AOME) demonstrated by myringotomy was analyzed as a specific subgroup of acute otitis media (AOM). Low birth weight (less than or equal to 2500 g) and prematurity (birth before the 37th gestational week) did not influence either AOM or AOME. The odds ratio for low birth weight infants becoming 'otitis-prone' (greater than or equal to 3 episodes of AOME) was 1.5 (0.9-2.1, P greater than 0.1). The various neonatal ventilation therapies were not associated with either AOM or AOME, but intermittent positive pressure ventilation, low birth weight and prematurity were distinctly related to wheezy bronchitis. The odds ratio regarding intermittent positive pressure ventilation was 2.0 (1.0-3.0, P less than 0.05) and that regarding low birth weight 1.7 (1.0-2.3, P less than 0.05). Boys had a slightly increased risk with respect to all the infective parameters. Birth order was closely correlated with the infective parameters, but much of this correlation was due to the postnatal effect of siblings. Altogether the antenatal and perinatal factors had only a slight effect on the infective parameters studied.

Acute Disease↗
PubMed1990

Risk factors for recurrent acute otitis media and respiratory infection in infancy.

Using a cohort-based design and random enrollment, the relation of various risk factors to acute otitis media, respiratory infection and wheezy bronchitis was studied in 2512 children from the fetal period to the age of two years. The complex interrelations of the risk factors with each other were separated out by multivariate analysis, and the confounding effects of antenatal parameters were also standardized. Acute otitis media with effusion (AOME), as demonstrated by myringotomy, was analyzed as a specific subgroup of acute otitis media (AOM). Day care in local authority nursery was the major risk factor for both types of acute otitis media. The odds ratio (OR) for such children becoming 'otitis-prone' (greater than or equal to 3 episodes of AOME) was 1.8 (95% confidence interval, 1.4-2.2). Short duration of breastfeeding involved another significant risk of recurrent respiratory infections and otitis media, the OR for AOME being 1.5 (1.1-2.0) and that for recurrent respiratory infection 1.3 (1.1-1.6). Allergy and family day care were also significantly associated with infective parameters, but to a lesser extent. The risk factors for wheezy bronchitis were the same as for infections, indicating that wheezy bronchitis is closely related to infections.

Acute Disease↗
PubMed1990

Perinatal risk for infants of unmarried mothers over a period of 20 years.

The perinatal events of the infants of 444 unmarried mothers, 3.7% of the total Northern Finland birth cohort from 1966, were compared with those of infants of 11,525 married mothers (95.5%), and a similar comparison was made between 395 (4.2%) unmarried mothers and 7516 (80.3%) married mothers in a second Northern Finland birth cohort in 1985-86. 1336 mothers, 14.3% of the mothers in this later cohort, were cohabiting. Divorced and widowed mothers were excluded from both cohorts. The infants of the unmarried mothers had a significantly lower mean birth weight, were more likely to be small for their gestational age (SGA), of low birth weight (LBW) (below 2500 g) and had a higher incidence of pre-term births than those of the married mothers in both cohorts. Perinatal mortality was significantly higher among the unmarried mothers only in the former cohort. These differences in perinatal events diminished markedly after adjustment for maternal age, parity, height, years of schooling and smoking habits, but did not totally disappear. The difference in the incidence of pre-term births diminished, but remained significant in both cohorts. The difference in mean birth weight, in the incidence of LBW infants and in perinatal mortality remained significantly less favourable to the unmarried mothers only in the 1966 cohort. It seems that the gap between the married and unmarried mothers had diminished. The incidence of SGA infants did not differ significantly between the married and unmarried mothers in either cohort after adjustment for the background variables. The cohabiting mothers formed an intermediate group between the married and single unmarried mothers in respect of perinatal events, but were close to the married mothers. In raw figures, the mean birth weight in this group was significantly lower and the incidence of SGA infants higher than among the married mothers, but these differences also disappeared after adjustment of the background variables.

Body Height↗
PubMed1990

Living habits and personality development of adolescent twins: a longitudinal follow-up study in a birth cohort from pregnancy to adolescence.

The living habits of 289 twins in a one-year birth cohort beginning during pregnancy and followed up to adolescence were compared with those of 11,623 singletons and two sets of controls matched either by maternal factors and place of residence only or by these and perinatal morbidity, all from the same cohort. The twins went in for sports more often than the singletons or any kind of controls. A nonsignificant trend was found indicating that twins smoked less often than their matched controls. The twins also used alcohol less often than their controls. The intrapair similarities of twins were higher than the similarities of twins and either type of controls in all four variables tested: sports, smoking, use of alcohol, as well as having been drunk.

Adolescent↗
PubMed1990

Changes in fertility and the acceptability of pregnancies in northern Finland during the last 20 years.

The acceptability of pregnancies was studied in two birth cohorts in Northern Finland which represent 96% of all births in the region in 1966 (12,068 births) and 99% (9362 births) in 1985-1986. The numbers of women of fertile age in the area during these years were 148,000 and 158,000, so that fertility may be said to have fallen from 81 to 59 per 1000. The pregnancy was wanted in 63.0% of cases and unwanted in 12.2% in 1966, the rest being classified as accepted later. The corresponding figures in 1985-1986 were 91.8% and 1.0%. The latter figures changed very little when maternal age, parity and social class were standardized to the 1966 levels. Acceptability was connected with age, in that the age groups in which childbearing was most frequent, 20-25 years in 1966 and 26-30 years in 1985-1986, had the highest incidence of desired pregnancies. In spite of the fact that there were 1.4 times as many births per woman aged 15-49 years in the former cohort, more wanted children were born to the age group 25-34 years in the latter cohort. The percentage of wanted pregnancies also varied with the woman's parity, social class and marital status. The children in the 1966 cohort were followed until the age of 14 and the incidences of cerebral palsy (CP) and mental retardation (IQ less than 71) were 3.2 times higher among the unwanted children than among the wanted ones.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Legal↗
PubMed1990

Changes in prognosis of twin births over 20 years.

The study is based on two birth cohorts from the years 1966 and 1985-1986. Perinatal mortality of twins has fallen over 20 years from 9.2% to 3.1%. Improvement is particularly remarkable in neonatal mortality (less than 28 days) of preterm (less than 34 gestational weeks) twins, from 47.4% to 8.6%, whereas the incidence of stillbirths has not fallen greatly. The proportion of preterm births has not fallen significantly, 48.4% vs. 38.1%. Many factors, considered favourable to the course and outcome of pregnancy have improved simultaneously: women are taller, less overweight, and more educated; pregnancies are wanted and sick and maternity leave provisions have improved. The follow-up of twin pregnancies and deliveries has been centralized and is more effective. In particular, neonatal care is also better than 20 years ago. The prognosis of twins has improved in parallel with the singletons, but the perinatal mortality is still approximately four time and the incidence of prematurity ten times more than in singletons.

Adult↗
PubMed1989

Secretory otitis media and hearing loss.

Hearing losses at 15 years of age were investigated in a material of 11,780 children born in Northern Finland in 1966 and followed-up since pregnancy. Two samples of the whole material, one representing a sample of 413 children with reported impaired hearing, and the other of 959 children with reported normal hearing were calculated to represent a total material of 11,748 cases. The correlation between the reported hearing and the audiometry results was very good. In the calculated material, 1,708 (14.6%) of the children exhibited a hearing loss exceeding 20 dB in at least one frequency in their school audiograms. The incidence of secretory otitis media as a risk diagnosis among those with impaired hearing was significantly higher than among those with normal hearing. Most of the hearing losses were found in the high frequencies.

Adolescent↗
PubMed1989

Long-term outcome for children with congenital heart defects. A study from 1 year birth cohort born in 1966 in northern Finland.

The incidence of congenital heart defects (CHD) in a birth cohort of 12,058 live births born in Northern Finland in 1966 was 4.15/1000 with a mortality due to CHD 1.41/1000 up to 14 years of age. The long-term social and educational outcome for CHD children was significantly poorer than for normal children of the same age when evaluated on the basis of school and army service records, and the incidence of cerebral palsy, epilepsy and mental retardation was significantly higher. 15.4% of the Down's syndrome cases in the cohort also had CHD. The CHD boys were significantly lighter in weight than the controls even as adolescents (14 years of age). The only difference between the operated and non-operated group was the higher weight of the boys at the age of 18 years in the former.

Adolescent↗
PubMed1989

The growth, development and education of Finnish twins: a longitudinal follow-up study in a birth cohort from pregnancy to nineteen years of age.

The growth, development and vocation of 289 twins in a one year birth cohort beginning during pregnancy and followed up to the age of 19 years was compared with that of 11,623 singletons and two sets of controls matched either by maternal factors only or by these and perinatal morbidity, all from the same cohort. The twins were more often pre-term and small for their gestational age, and had more often suffered from perinatal asphyxia, neonatal hyperbilirubinaemia and hypoglycemia. They had learned to walk without support later than the singletons and the controls matched only by maternal factors, but this difference did not exist between the twins and the controls also matched by perinatal morbidity. The same kind of result was found when studying the number of words spoken at the age of one year and physical growth at the ages of 1 and 14 years. The twins did not differ significantly from the singletons during their compulsory nine years of primary and secondary schooling. According to the national registers of vocational choices, the twins had applied for admission to further education courses less often than the singletons or their controls matched only by maternal factors, but not when compared with the controls also matched by perinatal morbidity. Logistic regression analysis revealed numerous perinatal or environmental factors having an adverse effect on educational achievements, but the twin situation itself was not shown to have adverse effects. About half of the same-sex twin pairs and one seventh of the opposite-sex pairs had chosen the same vocation, compared with just over 10% similarity between the twins and their controls.

Adolescent↗
PubMed1988

The single parent family and the child's mental health.

The prevalence of psychiatric and psychosomatic disorders in a 1 year birth cohort from northern Finland followed up until 19 years was examined on the basis of hospital records and national registers for subsidies for chronically sick children. Psychiatric disorders were found to occur with higher frequency in children of single parent families, especially those lacking a father during the child's whole life. Childhood enuresis was most frequent in the children who had experienced the divorce of their parents. Discriminant function analysis was used to establish the explanatory value of the family constellation for both psychiatric disorders and enuresis. The other significant explanatory variables for psychiatric disorders were school performance, place of residence and the child's height at 1 year of age, with poor school performance, high population density and short stature increasing the risk. The other significant variables increasing the risk of enuresis were psychiatric disorders, poor school performance, juvenile smoking and small size of dwelling. Disabled children had psychiatric disorders 9 times as frequently as non-disabled ones.

Cerebral Palsy↗
PubMed1988

The longitudinal study of the northern Finland birth cohort of 1966.

The Northern Finland birth cohort comprises 12,058 live births in 1966-96.3% of all births in the region. The investigation was started during pregnancy and the last follow-up of the total series was at the age of 14 years, when the coverage was still large. Smaller samples of the children and data for the study population from national registers were also examined for the older age groups. The health and development of the children was studied, with special emphasis placed on obtaining reliable incidence figures for neurological handicaps and their correlation with perinatal events. In particular, the correlation between low birthweight and handicapping conditions was documented thoroughly. The indicators predictive of low birthweight among the biological characteristics of the mother and the social conditions of the mother and family, included maternal smoking during pregnancy. The latter was associated not only with adverse perinatal outcome but also with reduction in educational achievement and height among survivors.

Adolescent↗